Abstract
BackgroundInvasive mole derives from hydatidiform mole, but its pathogenesis remains unknown. Invasive mole arising from iatrogenic uterine perforation has not been reported yet.Case presentationA reproductive woman was admitted because she suffered form severe abdominal pain and acute intra-abdominal hemorrhage after suction evacuation due to misdiagnosis as inevitable abortion. The patient underwent hysteroscopy and laparoscopy, by which an iatrogenic uterine perforation and omentum and pelvic peritoneum metastases were confirmed. All lesions were removed and the final pathological diagnosis was metastatic invasive mole. The patient underwent post-operative chemotherapy with methotrexate and presented a good prognosis.ConclusionInvasive mole arising form iatrogenic uterine perforation displays an unusual metastatic manner other than general invasive moles. The prevention of uterine perforation should be emphasized during suction evacuation for mole pregnancy.
Highlights
Invasive mole derives from hydatidiform mole, but its pathogenesis remains unknown
The prevention of uterine perforation should be emphasized during suction evacuation for mole pregnancy
Invasive mole is defined as the existence of edematous and/or degraded villus with trophoblastic proliferation in the myometrium or extra-uterine metastases which arises from myometrial invasion of hydatidiform mole via direct extension through tissue or venous channels
Summary
Invasive mole derives from hydatidiform mole, but its pathogenesis remains unknown. Invasive mole arising from iatrogenic uterine perforation has not been reported yet.Case presentation: A reproductive woman was admitted because she suffered form severe abdominal pain and acute intra-abdominal hemorrhage after suction evacuation due to misdiagnosis as inevitable abortion. Conclusion: Invasive mole arising form iatrogenic uterine perforation displays an unusual metastatic manner other than general invasive moles. The prevention of uterine perforation should be emphasized during suction evacuation for mole pregnancy. Invasive mole is often clinically rather than histologically diagnosed based on persistent elevated serum human chorionic gonadotropin (hCG) level after the evacuation of mole tissues.
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